NURS FPX 4025 Assessment 3

Name

Capella university

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Assessment 3

Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung condition that significantly impairs breathing, primarily due to smoking. Despite the well-documented risks, smoking cessation remains a difficult challenge for many individuals. COPD is among the leading causes of mortality in the United States, affecting nearly 16 million adults (Centers for Disease Control and Prevention [CDC], 2024). Quitting smoking can slow disease progression and improve overall health, but barriers such as nicotine addiction, stress, and lack of support often hinder successful cessation. This assessment evaluates the effectiveness of structured smoking cessation programs compared to standard counseling in helping COPD patients quit smoking. The goal is to determine which method more effectively promotes smoking cessation and enhances pulmonary health over a six-month period.

Explaining a Diagnosis

COPD is a chronic respiratory disease characterized by persistent coughing, shortness of breath, and frequent lung infections. Without proper management, the disease progressively worsens, leading to hospitalizations, cardiovascular complications, and respiratory failure. Smoking cessation is the primary intervention to slow COPD progression, yet many individuals struggle due to addiction, stress, or insufficient support systems (American Lung Association [ALA], 2024). Certain populations, including older adults, low-income individuals, and those with limited healthcare access, face additional challenges in managing COPD (Alupo et al., 2024). Financial constraints often prevent these patients from affording necessary medications, leading to worsening symptoms and increased hospital admissions. Additionally, those in remote areas may lack access to specialized care, limiting their ability to receive timely and effective treatment. Providing comprehensive smoking cessation programs and ensuring regular medical visits can mitigate these risks, ultimately improving patient outcomes (Wang et al., 2024). Nurses play a critical role in educating patients about COPD management and facilitating access to appropriate care.

Describing a Research Question

Addressing smoking cessation in COPD patients is essential for improving health outcomes and slowing disease progression. However, various barriers prevent many individuals from successfully quitting. Developing a research question using the PICO(T) framework helps identify the most effective smoking cessation strategy (Gosak et al., 2024). The research question is: In adult patients diagnosed with COPD (P), how does a structured smoking cessation program incorporating behavioral counseling and pharmacotherapy (I), compared to standard smoking cessation counseling (C), impact smoking cessation rates and pulmonary function (O) within six months (T)?

Breakdown of the PICO(T) Criteria

PICO(T) Criteria	Description
Population (P)	Adult patients diagnosed with COPD. This group is chosen due to the strong link between smoking and COPD progression, making cessation a crucial intervention.
Intervention (I)	A structured smoking cessation program, including behavioral counseling and pharmacotherapy (e.g., nicotine replacement therapy, varenicline, or bupropion). This approach has been shown to have higher success rates than single-intervention methods (Fu et al., 2022).
Comparison (C)	Standard smoking cessation counseling, which typically involves brief sessions or educational materials provided by healthcare professionals.
Outcome (O)	Sustained smoking cessation and improved pulmonary function, assessed over a six-month period.
Time (T)	A six-month timeframe, as research indicates that achieving sustained cessation beyond this period correlates with long-term smoking abstinence (Hu et al., 2021).

This research question aims to determine the effectiveness of structured smoking cessation programs in improving smoking cessation rates and lung function among COPD patients. The study findings will provide insights into best practices for COPD management and inform evidence-based clinical interventions.

Literature Search

A systematic literature review was conducted to identify research on smoking cessation interventions for COPD patients. Academic databases such as PubMed, CINAHL, Cochrane Library, and Google Scholar were utilized to ensure access to high-quality sources. The search terms included “COPD,” “smoking cessation,” “nicotine replacement therapy,” “behavioral counseling,” “pharmacotherapy,” and “pulmonary rehabilitation.” Boolean operators (AND, OR) were used to refine the search, ensuring relevance to COPD-specific smoking cessation interventions.

To ensure credibility, search results were filtered using the CRAAP criteria (Currency, Relevance, Authority, Accuracy, and Purpose). Peer-reviewed journal articles, systematic reviews, and meta-analyses from reputable sources, such as the CDC and ALA, were prioritized. The search strategy was further refined by incorporating specific keywords like “COPD patient adherence” and “effectiveness of structured cessation programs.” This approach ensured the inclusion of relevant and high-quality evidence to support best practices in COPD smoking cessation.

Relevant Articles

Several key studies provide strong evidence on the impact of smoking cessation programs for COPD patients. Wang et al. (2024) conducted a meta-analysis demonstrating that individuals who quit smoking showed significant improvements in lung function, walking ability, and oxygen levels. Their findings indicated a 6.72% increase in forced expiratory volume (FEV1%), a 64.46-meter increase in the six-minute walk test (6-MWT), and a 1.96% improvement in oxygen levels. Moreover, quitting smoking was associated with a 25% reduction in mortality risk (RR = 0.75).

Han et al. (2023) investigated the effectiveness of structured smoking cessation programs incorporating behavioral counseling, pharmacotherapy, and pulmonary rehabilitation. Their randomized controlled trial (RCT) found that combining nicotine replacement therapy (NRT) with cognitive-behavioral strategies significantly increased quit rates compared to standard counseling. Additionally, Fu et al. (2022) discussed the role of evidence-based practice models, such as the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, in implementing structured smoking cessation interventions. Their findings suggested that these interventions led to improved pulmonary function and slowed COPD progression. Collectively, these studies provide compelling evidence supporting structured smoking cessation programs as a superior approach for COPD management.

Analyzing Evidence

The existing research overwhelmingly supports the effectiveness of structured smoking cessation programs over standard counseling. Wang et al. (2024) highlighted substantial improvements in lung function, exercise capacity, and oxygenation following smoking cessation. Furthermore, Han et al. (2023) demonstrated that combining NRT with cognitive-behavioral therapy resulted in significantly higher quit rates. Fu et al. (2022) emphasized the importance of implementing evidence-based smoking cessation interventions within clinical practice. These findings confirm that structured programs, which integrate behavioral counseling and pharmacotherapy, lead to better cessation rates, enhanced pulmonary function, and improved long-term health outcomes.

Conclusion

Smoking cessation is essential for COPD management, as it slows disease progression and improves lung health. Research indicates that structured smoking cessation programs, which integrate behavioral counseling and pharmacotherapy, are more effective than standard counseling alone. These programs contribute to improved lung function, reduced hospitalizations, and overall better health outcomes for COPD patients. Nurses and healthcare providers can leverage structured smoking cessation programs to support patients in quitting smoking, thereby enhancing their quality of life and reducing the burden of COPD.

References

Alupo, P., Baluku, J., Bongomin, F., Siddharthan, T., Katagira, W., Ddungu, A., Hurst, J. R., Boven, van, Worodria, W., & Kirenga, B. J. (2024). Overcoming challenges of managing chronic obstructive pulmonary disease in low- and middle-income countries. Expert Review of Respiratory Medicine. https://doi.org/10.1080/17476348.2024.2398639

American Lung Association (ALA). (2024). Learn about COPD. American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd

Centers for Disease Control and Prevention (CDC). (2024). COPD. Chronic Disease Indicators. https://www.cdc.gov/cdi/indicator-definitions/chronic-obstructive-pulmonary-disease.html

NURS FPX 4025 Assessment 3

Fu, Y., Chapman, E. J., Boland, A. C., & Bennett, M. I. (2022). Evidence-based management approaches for patients with severe chronic obstructive pulmonary disease (COPD): A practice review. Palliative Medicine, 36(5), 770–782. https://doi.org/10.1177/02692163221079697

Han, M. K., Fu, Y., Ji, Q., Duan, X., & Fang, X. (2023). The effectiveness of theory-based smoking cessation interventions in patients with chronic obstructive pulmonary disease: A meta-analysis. BMC Public Health, 23(1). https://doi.org/10.1186/s12889-023-16441-w

Wang, Z., Qiu, Y., Ji, X., & Dong, L. (2024). Effects of smoking cessation on individuals with COPD: A systematic review and meta-analysis. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1433269